To contact us Click HERE
In China, chronic obstructive pulmonary disease (COPD) in people over the age of 40 is much more prevalent than previously thought, according to researchers in Guangdong.
Their findings appear in the second issue for October of the American Journal of Respiratory and Critical care Medicine, published by the American Thoracic Society. The investigators administered spirometric tests and questionnaires to a cross-sectional population in seven provinces/cities in China. Of the more than 20,000 who completed these materials, 8.2 percent of respondents over 40 met the criteria for having COPD.
Men were more than twice as likely to have COPD as women. But while smoking was, and is, a significant risk factor for COPD in China, only 24 percent of the females with COPD were smokers, as opposed to nearly 82 percent of males, suggesting that women's risk might be more strongly associated with the use of biomass fuels, especially for cooking in poorly ventilated areas.
"Although China has experienced remarkable modernization over the past two decades, in many rural areas residents continue to use wood, charcoal or coal for fuel, leading to significant biomass exposure, especially in women, who perform most of the cooking duties," wrote Don D. Sin, M.D., and Wan Tan, M.D., of the University of British Columbia in Vancouver, Canada, in an editorial in the same issue of the journal.
"To the best of our knowledge, this is the first large-scale, population-based epidemiologic study on COPD prevalence in China," wrote Nanshan Zhong, M.D., of the Guangzhou Institute of Respiratory Diseases at The First Affiliated Hospital in Guangzhou Medical College, and lead researcher.
According to an estimation by the World Health Organization, COPD ranks first among the burdens of diseases in China and accounts for one million deaths and five million disabilities each year.
The researchers selected provinces and cities from a wide range of geographic areas within China, and then selected an urban and a rural area within each province/city. They then used randomized cluster sampling from a randomly selected street or township, and attempted to recruit all individuals older than 40. About 79 percent of attempted were successfully contacted. They completed questionnaires and underwent spirometric testing for obstructive and restrictive lung disease.
While the overall rate of COPD, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) was higher than expected, there were some notable differences among the population.
"Multivariate logistic regression analyses showed that smoking, pulmonary problems in childhood, family history of respiratory diseases, male sex, low education level, aging, lower body mass index, poor ventilation in the kitchen, and exposure to biomass and occupational dust/gases/fumes are associated with COPD," wrote Dr. Zhong.
Importantly, more than a third of the subjects who had COPD were asymptomatic, and nearly two-thirds had never been diagnosed, suggesting that diagnosis of COPD on symptoms alone is not sufficient.
"Even among subjects with GOLD stages 3 and 4 of the disease, fewer than 10 percent have ever received spirometry," noted Drs. Sin and Tan. "The gross underutilization of spirometry represents a 'Great Wall,' a huge barrier to good care for patients with COPD in China."
Dr. Zhong and colleagues' findings present a dark picture of COPD in China, which is expected to grow worse before it gets better due to an aging population and rising smoking rates, especially in women.
"Our results highlight COPD as a major public health problem in China and call for more research to be directed toward preventative measures and efforts," wrote Dr. Zhong.
This news brief comes from the American Thoracic Society's peer-reviewed journal, the American Journal of Respiratory and Critical Care Medicine - ajrccm.atsjournals.
Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society has more than 18,000 members who prevent and fight respiratory disease around the globe, through research, education, patient care and advocacy.
thoracic
30 Eylül 2012 Pazar
Clinical Trial Data On The Safety And Efficacy Of Concomitant Formoterol Fumarate/ Tiotropium Treatment For COPD
To contact us Click HERE
Data presented at
CHEST 2007, the annual scientific assembly of the American College of Chest
Physicians (ACCP), demonstrate concomitant use of nebulized formoterol
fumarate and tiotropium provided improved bronchodilation over tiotropium
monotherapy and was well-tolerated in this clinical study. The only
commercially available version of nebulized formoterol fumarate is
Perforomist(TM) Inhalation Solution, which is indicated for long-term,
twice-daily maintenance treatment of bronchoconstriction for emphysema and
chronic bronchitis, also known as Chronic Obstructive Pulmonary Disease
(COPD).
Formoterol fumarate is a rapid and long-acting beta2-agonist (LABA)
that has been previously available in the U.S. in a dry powder formulation
and has twenty years of worldwide experience. Perforomist(TM) Inhalation
Solution is the first and only FDA-approved nebulized form of this
molecule. Nebulizers convert liquid medication into a mist that patients
inhale through a mouthpiece or face mask.
Results presented were from "Safety and Efficacy of Concomitant
Treatment with Nebulized Formoterol and Tiotropium in COPD," a randomized,
placebo-controlled Phase IIIb trial. The trial demonstrated that
concomitant therapy with twice-daily nebulized formoterol fumarate (FFIS)
and once-daily tiotropium provided patients with statistically significant
and clinically relevant improvements in bronchodilation over treatment with
tiotropium alone. In this six-week study, patients receiving concomitant
therapy with nebulized FFIS and tiotropium experienced fewer adverse events
or COPD exacerbations than patients receiving placebo or tiotropium
monotherapy.
According to Donald P. Tashkin, MD, FACP, FCCP, Professor of Medicine,
David Geffen School of Medicine at the University of California at Los
Angeles and the lead clinical investigator, "For the patients in this
study, adjunctive use of nebulized formoterol fumarate and tiotropium
showed statistically significant improvements in lung function by improving
bronchodilation over use of tiotropium alone. For physicians,
Perforomist(TM) Inhalation Solution and commonly prescribed long-acting
anticholinergics such as tiotropium offers a new and valuable treatment
option for COPD patients with moderate to severe manifestations of the
disease."
Christy Taylor, Chief Operating Officer at Dey, L.P., commented, "At
DEY, we specialize in developing effective new treatments for serious and
complex respiratory diseases, and it is gratifying that the newest addition
to our franchise, Perforomist(TM) Inhalation Solution, offers physicians
additional prescribing flexibility. For over a decade, Dey, L.P. has been
the U.S. leader in sales of nebulized respiratory medication. We thank Dr.
Tashkin and the other members of the research team for their assessment of
how Perforomist(TM) Inhalation Solution may be used concomitantly with
tiotropium for improved clinical effect for COPD patients."
For those attending CHEST 2007, the presentation is available as follows:
Poster viewing: Session ID 902 -- COPD Treatment II
Wednesday, October 24, 2007, 12:30 -- 2:00 PM
Convention Center, Exhibit Hall, McCormick Place, Lakeside Center, Chicago.
Poster # 251: Safety and Efficacy of Concomitant Treatment with Nebulized
Formoterol and Tiotropium in COPD
The research presented at CHEST 2007 was supported through grants
provided by Dey, L.P., which developed and markets Perforomist(TM)
Inhalation Solution. Dey, L.P. is a subsidiary of Mylan Inc. (NYSE: MYL).
About Perforomist(TM) Inhalation Solution
Indication
Perforomist(TM) Inhalation Solution is indicated for the long-term,
twice-daily (morning and evening) administration in the maintenance
treatment of bronchoconstriction in patients with chronic obstructive
pulmonary disease (COPD) including chronic bronchitis and emphysema.
Important Safety Information
Perforomist(TM) Inhalation Solution belongs to a class of medications
known as long-acting beta2-adrenergic agonists (LABAs). LABAs may increase
the risk of asthma-related death. Data from a large placebo-controlled US
study comparing the safety of another LABA (salmeterol) or placebo added to
usual asthma therapy showed an increase in asthma-related deaths in
patients receiving salmeterol. This finding with salmeterol may apply to
formoterol (a LABA), the active ingredient in Perforomist(TM) Inhalation
Solution.
Perforomist(TM) Inhalation Solution should not be used in patients with
acutely deteriorating COPD or to treat acute symptoms. Acute symptoms
should be treated with fast-acting rescue inhalers. Perforomist(TM)
Inhalation Solution should not be used with other medications containing
LABAs. Do not use more than one nebule twice daily. Perforomist(TM)
Inhalation Solution should be used with caution in patients with
cardiovascular disorders. Perforomist(TM) Inhalation Solution is not a
substitute for inhaled or oral corticosteroids. The safety and efficacy of
Perforomist(TM) Inhalation Solution in asthma has not been established.
In COPD clinical trials, the most common adverse events reported with
Perforomist(TM) Inhalation Solution were diarrhea, nausea, nasopharyngitis,
dry mouth, vomiting, dizziness, and insomnia.
About COPD
COPD refers to a number of chronic lung disorders in which the airways
to the lungs become narrowed and breathing becomes increasingly difficult.
The most common forms of COPD are chronic bronchitis and emphysema, and
many patients suffer from a combination of the two diseases.
COPD is the fourth leading cause of death in America, behind heart
disease, cancer and stroke. Twelve million Americans have been diagnosed
with COPD and at least another 12 million have symptoms but are not
diagnosed. COPD is not well understood or recognized -- most Americans have
not heard of it, not even those who may be living with the condition. The
most common cause of COPD is cigarette smoking, which is responsible for an
estimated 80 to 90 percent of COPD cases. Estimates of the total incidence
of COPD in America range from 24 to 30 million.
About Nebulization
Of the three types of devices used to deliver bronchodilators --
nebulizers, metered-dose inhalers, and dry powder inhalers -- nebulizers
require no special technique or coordination, as the medication is
converted into a fine mist that the patient inhales through a mouthpiece or
face-mask while breathing naturally. Because nebulization is an easy,
effective, and thorough method of delivering medicine directly into the
lungs, many COPD patients ask for it, particularly as their symptoms
worsen.
With Perforomist(TM) Inhalation Solution, nebulization may become a
more widely used treatment option for many COPD patients at earlier
treatment stages who could benefit from twice-daily maintenance dosing of a
nebulized LABA such as Perforomist(TM) Inhalation Solution. For example,
this new COPD treatment may be a valuable clinical option for many patients
who are not adequately controlled with short-acting bronchodilators.
About Dey, L.P.
Dey, L.P., a subsidiary of Mylan Inc. (NYSE: MYL), is a specialty
pharmaceutical company focused on the development, manufacturing and
marketing of prescription drug products for the treatment of respiratory
diseases, respiratory-related allergies, and emergency care medicine. As
the U.S. leader in sales of nebulized respiratory medication, Dey, L.P.
puts patients first through its development of innovative and affordable
therapies. The Web sites for Dey, L.P. include dey,
accuneb, curosurfusa, cyanokit, duoneb, epipen and perforomist.
Perforomist is a trademark of Dey, L.P.
About Mylan
Mylan Inc. is one of the world's leading quality generic and specialty
pharmaceutical companies. The Company offers one of the industry's broadest
and highest quality product portfolios, a robust product pipeline and a
global commercial footprint through operations in more than 90 countries.
Through its controlling interest in Matrix Laboratories Limited, Mylan has
direct access to one of the largest active pharmaceutical ingredient (API)
manufacturers in the world. Dey L.P., Mylan's fully integrated specialty
business, provides the Company with innovative and diversified
opportunities in the respiratory and allergy therapeutic areas.
For more information about Mylan, please visit mylan
This press release includes statements that constitute "forward-looking
statements," including with regard to the concomitant use of nebulized
formoterol fumarate and tiotropium and its effects. These statements are
made pursuant to the safe harbor provisions of the Private Securities
Litigation Reform Act of 1995. Because such statements inherently involve
risks and uncertainties, actual future results may differ materially from
those expressed or implied by such forward-looking statements. Factors that
could cause or contribute to such differences include, but are not limited
to: the risk that the adjunctive use may not ultimately prove to be as
successful as anticipated; the impact of the competitive COPD environment;
and the other risks detailed in the Company's Form 10-Q for the quarter
ended June 30, 2007 and its other periodic filings with the Securities and
Exchange Commission. The Company undertakes no obligation to update these
statements for revisions or changes after the date of this release.
Dey, L.P.
dey
CHEST 2007, the annual scientific assembly of the American College of Chest
Physicians (ACCP), demonstrate concomitant use of nebulized formoterol
fumarate and tiotropium provided improved bronchodilation over tiotropium
monotherapy and was well-tolerated in this clinical study. The only
commercially available version of nebulized formoterol fumarate is
Perforomist(TM) Inhalation Solution, which is indicated for long-term,
twice-daily maintenance treatment of bronchoconstriction for emphysema and
chronic bronchitis, also known as Chronic Obstructive Pulmonary Disease
(COPD).
Formoterol fumarate is a rapid and long-acting beta2-agonist (LABA)
that has been previously available in the U.S. in a dry powder formulation
and has twenty years of worldwide experience. Perforomist(TM) Inhalation
Solution is the first and only FDA-approved nebulized form of this
molecule. Nebulizers convert liquid medication into a mist that patients
inhale through a mouthpiece or face mask.
Results presented were from "Safety and Efficacy of Concomitant
Treatment with Nebulized Formoterol and Tiotropium in COPD," a randomized,
placebo-controlled Phase IIIb trial. The trial demonstrated that
concomitant therapy with twice-daily nebulized formoterol fumarate (FFIS)
and once-daily tiotropium provided patients with statistically significant
and clinically relevant improvements in bronchodilation over treatment with
tiotropium alone. In this six-week study, patients receiving concomitant
therapy with nebulized FFIS and tiotropium experienced fewer adverse events
or COPD exacerbations than patients receiving placebo or tiotropium
monotherapy.
According to Donald P. Tashkin, MD, FACP, FCCP, Professor of Medicine,
David Geffen School of Medicine at the University of California at Los
Angeles and the lead clinical investigator, "For the patients in this
study, adjunctive use of nebulized formoterol fumarate and tiotropium
showed statistically significant improvements in lung function by improving
bronchodilation over use of tiotropium alone. For physicians,
Perforomist(TM) Inhalation Solution and commonly prescribed long-acting
anticholinergics such as tiotropium offers a new and valuable treatment
option for COPD patients with moderate to severe manifestations of the
disease."
Christy Taylor, Chief Operating Officer at Dey, L.P., commented, "At
DEY, we specialize in developing effective new treatments for serious and
complex respiratory diseases, and it is gratifying that the newest addition
to our franchise, Perforomist(TM) Inhalation Solution, offers physicians
additional prescribing flexibility. For over a decade, Dey, L.P. has been
the U.S. leader in sales of nebulized respiratory medication. We thank Dr.
Tashkin and the other members of the research team for their assessment of
how Perforomist(TM) Inhalation Solution may be used concomitantly with
tiotropium for improved clinical effect for COPD patients."
For those attending CHEST 2007, the presentation is available as follows:
Poster viewing: Session ID 902 -- COPD Treatment II
Wednesday, October 24, 2007, 12:30 -- 2:00 PM
Convention Center, Exhibit Hall, McCormick Place, Lakeside Center, Chicago.
Poster # 251: Safety and Efficacy of Concomitant Treatment with Nebulized
Formoterol and Tiotropium in COPD
The research presented at CHEST 2007 was supported through grants
provided by Dey, L.P., which developed and markets Perforomist(TM)
Inhalation Solution. Dey, L.P. is a subsidiary of Mylan Inc. (NYSE: MYL).
About Perforomist(TM) Inhalation Solution
Indication
Perforomist(TM) Inhalation Solution is indicated for the long-term,
twice-daily (morning and evening) administration in the maintenance
treatment of bronchoconstriction in patients with chronic obstructive
pulmonary disease (COPD) including chronic bronchitis and emphysema.
Important Safety Information
Perforomist(TM) Inhalation Solution belongs to a class of medications
known as long-acting beta2-adrenergic agonists (LABAs). LABAs may increase
the risk of asthma-related death. Data from a large placebo-controlled US
study comparing the safety of another LABA (salmeterol) or placebo added to
usual asthma therapy showed an increase in asthma-related deaths in
patients receiving salmeterol. This finding with salmeterol may apply to
formoterol (a LABA), the active ingredient in Perforomist(TM) Inhalation
Solution.
Perforomist(TM) Inhalation Solution should not be used in patients with
acutely deteriorating COPD or to treat acute symptoms. Acute symptoms
should be treated with fast-acting rescue inhalers. Perforomist(TM)
Inhalation Solution should not be used with other medications containing
LABAs. Do not use more than one nebule twice daily. Perforomist(TM)
Inhalation Solution should be used with caution in patients with
cardiovascular disorders. Perforomist(TM) Inhalation Solution is not a
substitute for inhaled or oral corticosteroids. The safety and efficacy of
Perforomist(TM) Inhalation Solution in asthma has not been established.
In COPD clinical trials, the most common adverse events reported with
Perforomist(TM) Inhalation Solution were diarrhea, nausea, nasopharyngitis,
dry mouth, vomiting, dizziness, and insomnia.
About COPD
COPD refers to a number of chronic lung disorders in which the airways
to the lungs become narrowed and breathing becomes increasingly difficult.
The most common forms of COPD are chronic bronchitis and emphysema, and
many patients suffer from a combination of the two diseases.
COPD is the fourth leading cause of death in America, behind heart
disease, cancer and stroke. Twelve million Americans have been diagnosed
with COPD and at least another 12 million have symptoms but are not
diagnosed. COPD is not well understood or recognized -- most Americans have
not heard of it, not even those who may be living with the condition. The
most common cause of COPD is cigarette smoking, which is responsible for an
estimated 80 to 90 percent of COPD cases. Estimates of the total incidence
of COPD in America range from 24 to 30 million.
About Nebulization
Of the three types of devices used to deliver bronchodilators --
nebulizers, metered-dose inhalers, and dry powder inhalers -- nebulizers
require no special technique or coordination, as the medication is
converted into a fine mist that the patient inhales through a mouthpiece or
face-mask while breathing naturally. Because nebulization is an easy,
effective, and thorough method of delivering medicine directly into the
lungs, many COPD patients ask for it, particularly as their symptoms
worsen.
With Perforomist(TM) Inhalation Solution, nebulization may become a
more widely used treatment option for many COPD patients at earlier
treatment stages who could benefit from twice-daily maintenance dosing of a
nebulized LABA such as Perforomist(TM) Inhalation Solution. For example,
this new COPD treatment may be a valuable clinical option for many patients
who are not adequately controlled with short-acting bronchodilators.
About Dey, L.P.
Dey, L.P., a subsidiary of Mylan Inc. (NYSE: MYL), is a specialty
pharmaceutical company focused on the development, manufacturing and
marketing of prescription drug products for the treatment of respiratory
diseases, respiratory-related allergies, and emergency care medicine. As
the U.S. leader in sales of nebulized respiratory medication, Dey, L.P.
puts patients first through its development of innovative and affordable
therapies. The Web sites for Dey, L.P. include dey,
accuneb, curosurfusa, cyanokit, duoneb, epipen and perforomist.
Perforomist is a trademark of Dey, L.P.
About Mylan
Mylan Inc. is one of the world's leading quality generic and specialty
pharmaceutical companies. The Company offers one of the industry's broadest
and highest quality product portfolios, a robust product pipeline and a
global commercial footprint through operations in more than 90 countries.
Through its controlling interest in Matrix Laboratories Limited, Mylan has
direct access to one of the largest active pharmaceutical ingredient (API)
manufacturers in the world. Dey L.P., Mylan's fully integrated specialty
business, provides the Company with innovative and diversified
opportunities in the respiratory and allergy therapeutic areas.
For more information about Mylan, please visit mylan
This press release includes statements that constitute "forward-looking
statements," including with regard to the concomitant use of nebulized
formoterol fumarate and tiotropium and its effects. These statements are
made pursuant to the safe harbor provisions of the Private Securities
Litigation Reform Act of 1995. Because such statements inherently involve
risks and uncertainties, actual future results may differ materially from
those expressed or implied by such forward-looking statements. Factors that
could cause or contribute to such differences include, but are not limited
to: the risk that the adjunctive use may not ultimately prove to be as
successful as anticipated; the impact of the competitive COPD environment;
and the other risks detailed in the Company's Form 10-Q for the quarter
ended June 30, 2007 and its other periodic filings with the Securities and
Exchange Commission. The Company undertakes no obligation to update these
statements for revisions or changes after the date of this release.
Dey, L.P.
dey
Budesonide Added To Formoterol And/or Short Acting Beta 2 Agonist Lowers Mortality Risk For Severe COPD Patients
To contact us Click HERE
Important new data from the analysis of combined data from the two pivotal Symbicort(R) studies, announced today at the 5th International Multidisciplinary Conference on Chronic Obstructive Pulmonary Disease (COPD5), reveals that budesonide added to formoterol (Symbicort (R)) and/or terbutaline significantly reduces mortality in severe COPD over one year, compared to the bronchodilators formoterol and/or terbutaline alone.
Today's results show fewer deaths in the Symbicort / budesonide group compared with the bronchodilator group (p=0.036), with an associated hazard ratio of 0.564 (p=0.039). This represents a 44% reduction in all-cause mortality over one year for patients treated with Symbicort / budesonide1 .
"Previous findings have shown the beneficial effects of combination budesonide and formoterol, i.e. Symbicort, therapy in significantly reducing COPD exacerbations", explained Professor Peter Calverley, Aintree Chest Centre, University of Liverpool. "Today's presentation further demonstrates the link between COPD exacerbations and an increased risk of mortality, reinforcing the importance of reducing these events, as indicated by COPD guidelines".
The re-analysis comprised data from 1834 patients with severe COPD evenly distributed between the two treatment groups, i.e. budesonide added to bronchodilators compared to bronchodilators alone.
The survival benefits in this analysis also appear to corroborate the findings in the three year prospective TORCH (TOwards a Revolution in COPD health) study2, presented at the American Thoracic Society Congress in 2006, which has reported a 17% reduction in mortality for fluticasone/salmeterol compared with placebo.
The retrospective pooled analysis also showed that health-related quality of life (HRQL) - as measured by the St. Georges Respiratory Questionnaire (SGRQ), an independently validated tool for measuring quality of life in COPD - was the strongest predictor of mortality in COPD, over and above any other reported predictor (e.g. lung function, breathlessness, Body Mass Index and age), equating to better quality of life leading to lower risk of premature death3. Using the SGRQ, a change of four points is defined as clinically meaningful, equating to a patient being able to walk up a flight of stairs without stopping or to being able to sleep without disruption from coughing. The data presented today suggests that SGRQ scores may have a role in identifying patients at increased risk of mortality over 1 year.
"Previous studies have demonstrated that budesonide/ formoterol is a very effective treatment in preventing COPD exacerbations, leading to clinically important improvements in health-related quality of life", explained Professor Paul Jones, St George's Hospital Medical School, London "Today's data are important, suggesting as it does that a combination of budesonide and formoterol may provide a tangible survival benefit as well as improving the patients quality of life".
The pooled-analysis, presented today at COPD5, is based upon the data from two 1-year prospective Symbicort studies in COPD (Calverley et al. 4 and Szafranski et al5), both published in the European Respiratory Journal in 2003.
"Randomised, controlled trials are the best way of determining whether therapy is effective in COPD. However, re-analysis of pooled data from comparable clinical trials, as we did in this case, can provide new and potentially important clinical insights", Professor Calverley concluded.
References:
1 Peter Calverley, Paul Jones, Thomas Larsson, Stefan Peterson. Preventing mortality in COPD: The value of inhaled budesonide added to bronchodilators. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
2 TORCH Study Group. The TORCH (TOwards a Revolution in COPD health) survival study protocol Eur Respir J 2004;24:206-210
3 Paul Jones, Peter Calverley, Thomas Larsson, Stefan Peterson. SGRQ scores may help identify COPD patients at increased risk of death in 1 year. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
4 Calverley PM, Boonsawat Z, Zhong N, Peterson S and Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Resp J 2003; 22; 912-919.
5 Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, Peterson S, Olsson H. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Resp J 2003; 21: 74-81.
astrazeneca
Today's results show fewer deaths in the Symbicort / budesonide group compared with the bronchodilator group (p=0.036), with an associated hazard ratio of 0.564 (p=0.039). This represents a 44% reduction in all-cause mortality over one year for patients treated with Symbicort / budesonide1 .
"Previous findings have shown the beneficial effects of combination budesonide and formoterol, i.e. Symbicort, therapy in significantly reducing COPD exacerbations", explained Professor Peter Calverley, Aintree Chest Centre, University of Liverpool. "Today's presentation further demonstrates the link between COPD exacerbations and an increased risk of mortality, reinforcing the importance of reducing these events, as indicated by COPD guidelines".
The re-analysis comprised data from 1834 patients with severe COPD evenly distributed between the two treatment groups, i.e. budesonide added to bronchodilators compared to bronchodilators alone.
The survival benefits in this analysis also appear to corroborate the findings in the three year prospective TORCH (TOwards a Revolution in COPD health) study2, presented at the American Thoracic Society Congress in 2006, which has reported a 17% reduction in mortality for fluticasone/salmeterol compared with placebo.
The retrospective pooled analysis also showed that health-related quality of life (HRQL) - as measured by the St. Georges Respiratory Questionnaire (SGRQ), an independently validated tool for measuring quality of life in COPD - was the strongest predictor of mortality in COPD, over and above any other reported predictor (e.g. lung function, breathlessness, Body Mass Index and age), equating to better quality of life leading to lower risk of premature death3. Using the SGRQ, a change of four points is defined as clinically meaningful, equating to a patient being able to walk up a flight of stairs without stopping or to being able to sleep without disruption from coughing. The data presented today suggests that SGRQ scores may have a role in identifying patients at increased risk of mortality over 1 year.
"Previous studies have demonstrated that budesonide/ formoterol is a very effective treatment in preventing COPD exacerbations, leading to clinically important improvements in health-related quality of life", explained Professor Paul Jones, St George's Hospital Medical School, London "Today's data are important, suggesting as it does that a combination of budesonide and formoterol may provide a tangible survival benefit as well as improving the patients quality of life".
The pooled-analysis, presented today at COPD5, is based upon the data from two 1-year prospective Symbicort studies in COPD (Calverley et al. 4 and Szafranski et al5), both published in the European Respiratory Journal in 2003.
"Randomised, controlled trials are the best way of determining whether therapy is effective in COPD. However, re-analysis of pooled data from comparable clinical trials, as we did in this case, can provide new and potentially important clinical insights", Professor Calverley concluded.
References:
1 Peter Calverley, Paul Jones, Thomas Larsson, Stefan Peterson. Preventing mortality in COPD: The value of inhaled budesonide added to bronchodilators. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
2 TORCH Study Group. The TORCH (TOwards a Revolution in COPD health) survival study protocol Eur Respir J 2004;24:206-210
3 Paul Jones, Peter Calverley, Thomas Larsson, Stefan Peterson. SGRQ scores may help identify COPD patients at increased risk of death in 1 year. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
4 Calverley PM, Boonsawat Z, Zhong N, Peterson S and Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Resp J 2003; 22; 912-919.
5 Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, Peterson S, Olsson H. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Resp J 2003; 21: 74-81.
astrazeneca
Kamada Completes Enrollment In Its Phase II Bronchiectasis Trial With Inhaled AAT
To contact us Click HERE
Kamada (TASE:KMDA), a biopharmaceutical company engaged in the development, production and marketing of specialty life-saving biotherapeutics, announced recently that it has completed patient enrollment in its Phase II clinical trial evaluating treatment of bronchiectasis patients with inhaled Alpha-1 Antitrypsin (AAT) delivered by the investigational eFlow® nebulizer system (PARI Pharma GmbH).
Chief Executive Officer of Kamada, David Tsur, said, "We are very pleased with the progress of this study and look forward to its upcoming completion. We believe that Kamada's AAT delivered by PARI's eFlow® has the potential to become a novel treatment for bronchiectasis. Kamada is committed to the development of inhaled AAT to treat bronchiectasis and to proceed with its ongoing clinical efforts in Alpha 1 Antitrypsin Deficiency and Cystic Fibrosis."
About the study
A total of 21 patients with brochiectasis were enrolled and randomized into this , double-blind, placebo controlled Phase II study. The purpose of the trial is to investigate safety and efficacy of inhaled AAT in this patient population.
About Kamada's Inhaled AAT
Kamada's AAT product has the advantages of a high purity preparation combined with a liquid, ready to use, presentation that does not include stabilizers or preservatives. Efficacy trends towards reduction in lung inflammation were also shown recently by inhaled AAT in a phase II cystic fibrosis study sided to a high safety profile for the given study period.
Kamada's inhaled AAT, which is delivered via an optimized Investigational eFlow Nebulizer System (PARI Pharma GmbH), has received Orphan Drug Designation from the US FDA for the bronchiectasis indication.
About Bronchiectasis
Bronchiectasis is an abnormal stretching and enlarging of the airways. Bronchiectasis patients usually suffer from recurrent, severe episodes of bronchitis, chronic cough and sputum production. According to the US COPD foundation approximately 600,000 individuals suffer from bronchiectasis worldwide, with an estimated 100,000 people in the US alone (excluding cystic fibrosis patients).
About PARI Pharma and the Investigational eFlow® Nebulizer System
Kamada's Inhaled AAT is delivered by the Investigational eFlow Nebulizer System (PARI Pharma GmbH). The Investigational eFlow Nebulizer System uses eFlow Technology to enable extremely efficient aerosolization of liquid medications via a vibrating, perforated membrane that includes thousands of small holes that produce the aerosol mist. Compared to other nebulization technologies, eFlow Technology produces aerosols with a very high density of active drug, a precisely defined droplet size, and a high proportion of respirable droplets delivered in the shortest possible period of time. Combined with its silent mode of operation, small size (it fits in the palm of your hand), light weight, and battery use, eFlow Technology reduces the burden of taking daily, inhaled treatments. The Investigational eFlow Nebulizer System and eFlow Technology are proprietary to PARI Pharma and can be optimized to specific drug formulations.
PARI Pharma focuses on the development of aerosol delivery devices and therapies. Based on PARI's 100-year history working with aerosols, PARI Pharma develops treatments for pulmonary and nasal administration optimized with advanced delivery technologies, such as eFlow technology. Online at PariPharma.
About Kamada
Kamada is a public biopharmaceutical company (kamada) developing, producing and marketing a line of specialty life-saving biopharmaceuticals using its proprietary chromatographic purification technologies. Several of these specialty therapeutics are currently undergoing advanced clinical trials.
Chief Executive Officer of Kamada, David Tsur, said, "We are very pleased with the progress of this study and look forward to its upcoming completion. We believe that Kamada's AAT delivered by PARI's eFlow® has the potential to become a novel treatment for bronchiectasis. Kamada is committed to the development of inhaled AAT to treat bronchiectasis and to proceed with its ongoing clinical efforts in Alpha 1 Antitrypsin Deficiency and Cystic Fibrosis."
About the study
A total of 21 patients with brochiectasis were enrolled and randomized into this , double-blind, placebo controlled Phase II study. The purpose of the trial is to investigate safety and efficacy of inhaled AAT in this patient population.
About Kamada's Inhaled AAT
Kamada's AAT product has the advantages of a high purity preparation combined with a liquid, ready to use, presentation that does not include stabilizers or preservatives. Efficacy trends towards reduction in lung inflammation were also shown recently by inhaled AAT in a phase II cystic fibrosis study sided to a high safety profile for the given study period.
Kamada's inhaled AAT, which is delivered via an optimized Investigational eFlow Nebulizer System (PARI Pharma GmbH), has received Orphan Drug Designation from the US FDA for the bronchiectasis indication.
About Bronchiectasis
Bronchiectasis is an abnormal stretching and enlarging of the airways. Bronchiectasis patients usually suffer from recurrent, severe episodes of bronchitis, chronic cough and sputum production. According to the US COPD foundation approximately 600,000 individuals suffer from bronchiectasis worldwide, with an estimated 100,000 people in the US alone (excluding cystic fibrosis patients).
About PARI Pharma and the Investigational eFlow® Nebulizer System
Kamada's Inhaled AAT is delivered by the Investigational eFlow Nebulizer System (PARI Pharma GmbH). The Investigational eFlow Nebulizer System uses eFlow Technology to enable extremely efficient aerosolization of liquid medications via a vibrating, perforated membrane that includes thousands of small holes that produce the aerosol mist. Compared to other nebulization technologies, eFlow Technology produces aerosols with a very high density of active drug, a precisely defined droplet size, and a high proportion of respirable droplets delivered in the shortest possible period of time. Combined with its silent mode of operation, small size (it fits in the palm of your hand), light weight, and battery use, eFlow Technology reduces the burden of taking daily, inhaled treatments. The Investigational eFlow Nebulizer System and eFlow Technology are proprietary to PARI Pharma and can be optimized to specific drug formulations.
PARI Pharma focuses on the development of aerosol delivery devices and therapies. Based on PARI's 100-year history working with aerosols, PARI Pharma develops treatments for pulmonary and nasal administration optimized with advanced delivery technologies, such as eFlow technology. Online at PariPharma.
About Kamada
Kamada is a public biopharmaceutical company (kamada) developing, producing and marketing a line of specialty life-saving biopharmaceuticals using its proprietary chromatographic purification technologies. Several of these specialty therapeutics are currently undergoing advanced clinical trials.
29 Eylül 2012 Cumartesi
Closed Circuit Breathing Device Could Transform The Lives Of Patients With Chronic Obstructive Pulmonary Disease
To contact us Click HERE
A UNIQUE partnership between Smiths Medical, part of the FTSE 100
technology business Smiths Group, and University College London (UCL)
has resulted in the development of a breakthrough clinical device that
could transform the lives of patients with COPD across the world. COPD
will be the third leading cause of death worldwide by 2030, according to
the World Health Organisation (WHO).
The new technology is based on a closed circuit oxygen device invented
over 50 years ago by the British rocket scientist Tom Bourdillon, who
hoped that it would help take him to the top of the world.
Three days before Edmund Hillary and Tenzing Norgay made the first
ascent of Mount Everest in 1953, Bourdillon nearly got there first with
the help of his ground-breaking invention. When he and his climbing
partner Charles Evans, a British brain surgeon, set out on the first
ever summit attempt they were breathing pure oxygen from the device. It
helped them climb higher than any man had ever been before and at speeds
that have rarely been matched since.
The two men were just 90 metres from the summit when Evans' device
malfunctioned dashing their hopes of becoming the most celebrated
mountaineers in the world. Three days later Hillary and Norgay claimed
that honour using open circuit oxygen devices.
Bourdillon believed that closed circuit oxygen was more efficient and
effective than open circuit because a closed circuit efficiently
recycles exhaled oxygen, which would be lost to the atmosphere in an
open circuit.
His research was forgotten for 50 years but now Smiths Medical and UCL
have developed Bourdillon's idea into a breakthrough medical device that
could help patients with COPD, which is a disease of the lungs in which
the airways become narrowed leading to a limitation of the flow of air
to and from the lungs, causing shortness of breath.
"We are hoping that this new technology will transform the lives of
people living with COPD by allowing them to breathe more easily,
exercise and ultimately reduce their dependence on oxygen. It is
incredible to think that this breakthrough device is based on a British
invention designed to help the first mountaineers reach the top of the
world," said Dr Jeremy Russell, head of research and development at
Smiths Medical International.
Bourdillon's research was rediscovered by Jeremy Windsor and Roger
McMorrow, mountaineering scientists at the UCL Centre for Altitude,
Space and Extreme Environment Medicine (CASE), who had the idea to
redevelop it into a modern breathing circuit for climbers.
"Bourdillon recognized that the problem on Everest was low levels of
oxygen and if you solved the problem of delivering oxygen you would
effectively reduce the height of the mountain to sea level," said Dr
McMorrow. "No-one knows exactly why his device failed but when I tested
my prototype on Cho Oyu in the Himalayas 2005 it also failed. In my case
the soda lime CO2 absorber malfunctioned and it is possible Bourdillon
had the same problem although another theory is that it was a frozen
valve. A recently invented CO2 absorber called ExtendAir solved the
problem on my circuit."
Dr McMorrow, when a Smiths Medical Research Fellow at UCL, showed his
mountaineering prototype to Dr Russell at Smiths Medical, which has a
long-standing partnership with UCL that includes collaboration on
research in the field of respiratory medicine. The two scientists
quickly realized that the prototype for mountaineers had the potential
to evolve into a ground-breaking device for COPD patients as well as for
other patients weaning from oxygen in hospital and those on home oxygen.
Last year the device was successfully tested on Mount Everest at the
Smiths Medical High Altitude Laboratory at Namche Bazaar, Nepal at
3,400m, (11,154 ft) as part of the Caudwell Xtreme Everest Study (CXE),
a medical research project conducted by CASE. Smiths Medical is now
optimizing and miniaturizing the prototype for patients.
Exercise is important for COPD patients but existing oxygen systems mean
it is often not possible. The size of current open circuit systems mean
that patients are often confined to their hospital beds or treated at
home with large cylinders that severely restrict their mobility.
Portable open circuit systems are not able to deliver high enough
volumes of oxygen for long enough to permit exercise. In an open circuit
system the faster a person breathes the more they dilute the oxygen with
ordinary air. This means that if a patient dependent on oxygen starts to
exercise their oxygen levels actually drop as their breathing grows
faster.
Dr Russell added: "The new system is portable and should deliver a very
high concentration of oxygen for a sustained period of time. It should
help keep oxygen levels constant no matter how fast or slow a patient is
breathing."
Previously, portable closed circuits have been used by Special Forces
frogmen (because there are no bubbles), mine rescue workers,
firefighters and in bioterrorism suits.
George Band, who was the youngest member of the 1953 Everest expedition,
said: "I remember how passionate Tom was about his closed circuit device
and how disappointed he and Charles were not to make it to the summit.
I'm sure Tom would have been really thrilled that his research on the
closed-circuit oxygen equipment did not go to waste and could help
people suffering from respiratory problems today."
Professor Monty Mythen, Smiths Medical Professor of Anaesthesia at UCL
and Director of Research and Development at UCL Hospitals said: "This
project is a fantastic example of the success that comes from scientists
in industry working closely with clinicians and university academics for
patient benefit. Smiths Medical in collaboration with UCL and NHS
Partners makes a formidable team and I am delighted that the Caudwell
Xtreme Everest expedition is beginning to reap rewards for patients."
COPD
COPD stands for chronic obstructive pulmonary disease. This is a term
used for a number of conditions including chronic bronchitis and
emphysema. COPD leads to damaged airways in the lungs, causing them to
become narrower and making it harder for air to get in and out of the
lungs. The word 'chronic' means that the problem is long-term. The WHO
predicts it will be the third leading cause of death worldwide by 2030.
Smiths Medical
Smiths Medical is a leading supplier of high-quality medical devices and
products for global markets. It designs and manufactures specialist
medical devices in three key areas: Safety Devices, Vital Care and
Medication Delivery. Smiths Medical's customers include hospitals,
alternate care such as home care, and other healthcare providers
worldwide. Smiths Medical is part of the global technology business
Smiths Group, a world leader in the practical application of advanced
technologies. Smiths is a global technology company listed on the London
Stock Exchange. For further information, visit smiths-medical
Smiths Group
Smiths is a global technology company listed on the London Stock
Exchange. A world leader in the practical application of advanced
technologies, Smiths Group delivers products and services for the threat
& contraband detection, medical devices, energy and communications
markets worldwide. Our products and services make the world safer,
healthier and more productive. Smiths Group employs more than 20,000
people in over 50 countries. For more information visit smiths
Caudwell Xtreme Everest (CXE)
Caudwell Xtreme Everest is a research project coordinated by the UCL
Centre for Altitude, Space and Extreme (CASE) environment medicine -
doctors and scientists studying human systems stretched to breaking
point in extreme environments to increase our understanding of
critically ill patients. The goal is to place a research team on the
summit of Mount Everest in 2007 and make the first ever measurement of
the level of oxygen in human blood at this altitude. This is the
centrepiece of an extensive programme of research into hypoxia (low
oxygen levels) and human performance at extreme altitude aimed at
improving the care of the critically ill and other patients where
hypoxia is a fundamental problem. The Caudwell Xtreme Everest
expedition is being sponsored by John Caudwell, a businessman and
founder of The Caudwell Charity. Scientific studies in the run-up to
the expedition have been supported by a research grant from medical
gases specialist BOC Medical.
Caudwell Xtreme Everest
technology business Smiths Group, and University College London (UCL)
has resulted in the development of a breakthrough clinical device that
could transform the lives of patients with COPD across the world. COPD
will be the third leading cause of death worldwide by 2030, according to
the World Health Organisation (WHO).
The new technology is based on a closed circuit oxygen device invented
over 50 years ago by the British rocket scientist Tom Bourdillon, who
hoped that it would help take him to the top of the world.
Three days before Edmund Hillary and Tenzing Norgay made the first
ascent of Mount Everest in 1953, Bourdillon nearly got there first with
the help of his ground-breaking invention. When he and his climbing
partner Charles Evans, a British brain surgeon, set out on the first
ever summit attempt they were breathing pure oxygen from the device. It
helped them climb higher than any man had ever been before and at speeds
that have rarely been matched since.
The two men were just 90 metres from the summit when Evans' device
malfunctioned dashing their hopes of becoming the most celebrated
mountaineers in the world. Three days later Hillary and Norgay claimed
that honour using open circuit oxygen devices.
Bourdillon believed that closed circuit oxygen was more efficient and
effective than open circuit because a closed circuit efficiently
recycles exhaled oxygen, which would be lost to the atmosphere in an
open circuit.
His research was forgotten for 50 years but now Smiths Medical and UCL
have developed Bourdillon's idea into a breakthrough medical device that
could help patients with COPD, which is a disease of the lungs in which
the airways become narrowed leading to a limitation of the flow of air
to and from the lungs, causing shortness of breath.
"We are hoping that this new technology will transform the lives of
people living with COPD by allowing them to breathe more easily,
exercise and ultimately reduce their dependence on oxygen. It is
incredible to think that this breakthrough device is based on a British
invention designed to help the first mountaineers reach the top of the
world," said Dr Jeremy Russell, head of research and development at
Smiths Medical International.
Bourdillon's research was rediscovered by Jeremy Windsor and Roger
McMorrow, mountaineering scientists at the UCL Centre for Altitude,
Space and Extreme Environment Medicine (CASE), who had the idea to
redevelop it into a modern breathing circuit for climbers.
"Bourdillon recognized that the problem on Everest was low levels of
oxygen and if you solved the problem of delivering oxygen you would
effectively reduce the height of the mountain to sea level," said Dr
McMorrow. "No-one knows exactly why his device failed but when I tested
my prototype on Cho Oyu in the Himalayas 2005 it also failed. In my case
the soda lime CO2 absorber malfunctioned and it is possible Bourdillon
had the same problem although another theory is that it was a frozen
valve. A recently invented CO2 absorber called ExtendAir solved the
problem on my circuit."
Dr McMorrow, when a Smiths Medical Research Fellow at UCL, showed his
mountaineering prototype to Dr Russell at Smiths Medical, which has a
long-standing partnership with UCL that includes collaboration on
research in the field of respiratory medicine. The two scientists
quickly realized that the prototype for mountaineers had the potential
to evolve into a ground-breaking device for COPD patients as well as for
other patients weaning from oxygen in hospital and those on home oxygen.
Last year the device was successfully tested on Mount Everest at the
Smiths Medical High Altitude Laboratory at Namche Bazaar, Nepal at
3,400m, (11,154 ft) as part of the Caudwell Xtreme Everest Study (CXE),
a medical research project conducted by CASE. Smiths Medical is now
optimizing and miniaturizing the prototype for patients.
Exercise is important for COPD patients but existing oxygen systems mean
it is often not possible. The size of current open circuit systems mean
that patients are often confined to their hospital beds or treated at
home with large cylinders that severely restrict their mobility.
Portable open circuit systems are not able to deliver high enough
volumes of oxygen for long enough to permit exercise. In an open circuit
system the faster a person breathes the more they dilute the oxygen with
ordinary air. This means that if a patient dependent on oxygen starts to
exercise their oxygen levels actually drop as their breathing grows
faster.
Dr Russell added: "The new system is portable and should deliver a very
high concentration of oxygen for a sustained period of time. It should
help keep oxygen levels constant no matter how fast or slow a patient is
breathing."
Previously, portable closed circuits have been used by Special Forces
frogmen (because there are no bubbles), mine rescue workers,
firefighters and in bioterrorism suits.
George Band, who was the youngest member of the 1953 Everest expedition,
said: "I remember how passionate Tom was about his closed circuit device
and how disappointed he and Charles were not to make it to the summit.
I'm sure Tom would have been really thrilled that his research on the
closed-circuit oxygen equipment did not go to waste and could help
people suffering from respiratory problems today."
Professor Monty Mythen, Smiths Medical Professor of Anaesthesia at UCL
and Director of Research and Development at UCL Hospitals said: "This
project is a fantastic example of the success that comes from scientists
in industry working closely with clinicians and university academics for
patient benefit. Smiths Medical in collaboration with UCL and NHS
Partners makes a formidable team and I am delighted that the Caudwell
Xtreme Everest expedition is beginning to reap rewards for patients."
COPD
COPD stands for chronic obstructive pulmonary disease. This is a term
used for a number of conditions including chronic bronchitis and
emphysema. COPD leads to damaged airways in the lungs, causing them to
become narrower and making it harder for air to get in and out of the
lungs. The word 'chronic' means that the problem is long-term. The WHO
predicts it will be the third leading cause of death worldwide by 2030.
Smiths Medical
Smiths Medical is a leading supplier of high-quality medical devices and
products for global markets. It designs and manufactures specialist
medical devices in three key areas: Safety Devices, Vital Care and
Medication Delivery. Smiths Medical's customers include hospitals,
alternate care such as home care, and other healthcare providers
worldwide. Smiths Medical is part of the global technology business
Smiths Group, a world leader in the practical application of advanced
technologies. Smiths is a global technology company listed on the London
Stock Exchange. For further information, visit smiths-medical
Smiths Group
Smiths is a global technology company listed on the London Stock
Exchange. A world leader in the practical application of advanced
technologies, Smiths Group delivers products and services for the threat
& contraband detection, medical devices, energy and communications
markets worldwide. Our products and services make the world safer,
healthier and more productive. Smiths Group employs more than 20,000
people in over 50 countries. For more information visit smiths
Caudwell Xtreme Everest (CXE)
Caudwell Xtreme Everest is a research project coordinated by the UCL
Centre for Altitude, Space and Extreme (CASE) environment medicine -
doctors and scientists studying human systems stretched to breaking
point in extreme environments to increase our understanding of
critically ill patients. The goal is to place a research team on the
summit of Mount Everest in 2007 and make the first ever measurement of
the level of oxygen in human blood at this altitude. This is the
centrepiece of an extensive programme of research into hypoxia (low
oxygen levels) and human performance at extreme altitude aimed at
improving the care of the critically ill and other patients where
hypoxia is a fundamental problem. The Caudwell Xtreme Everest
expedition is being sponsored by John Caudwell, a businessman and
founder of The Caudwell Charity. Scientific studies in the run-up to
the expedition have been supported by a research grant from medical
gases specialist BOC Medical.
Caudwell Xtreme Everest
Children With Severe Asthma At Increased Risk Of Developing COPD
To contact us Click HERE
Children with severe asthma have more than 30 times the risk of developing adult chronic obstructive lung disease (COPD) as adults compared to children without asthma, according to a prospective longitudinal cohort study from the Royal Children's Hospital in Melbourne.
The results will be presented at the ATS 2010 International Conference in New Orleans.
"There is important epidemiological evidence to suggest that events in childhood that influence lung growth constitute a significant risk for COPD," explained lead author, Andrew Tai, MBBS, FRACP. "The aim of this study was to describe the association between the pattern of childhood asthma and the risk of developing adult COPD in a longitudinal cohort."
Subjects of the Melbourne Asthma Study were recruited at the age of seven, from a 1957 birth cohort and were assessed regularly until the age of 50. At recruitment, subjects were classified as having no history of wheeze, intermittent asthma (such as viral-induced wheezing), persistent asthma (in the absence of illness), or severe asthma. Of the surviving members of the original group, 197 answered a detailed questionnaire and underwent lung function testing for the current study.
Subjects who were classified as having severe asthma in childhood had an adjusted risk of COPD of 31.9 times that of children without asthma. Interestingly, children with mild asthma were not at increased risk of developing adult obstructive lung disease.
"At this stage, children with mild asthma are those who have symptoms of wheeze which are triggered primarily by respiratory infections. A majority [of children with mild asthma] remit by adolescence or adulthood," explained Dr. Tai. "However, children with more severe asthma features tend to have predisposing risk factors (like atopy) and continue to have symptoms of wheeze well into adult life."
"It is important to emphasize that the lung function decline in this group is not increased compared to those with mild or no asthma, as has been raised in some other studies," Dr. Tai continued. "However, lung function in children with severe asthma are reduced in childhood years and decline in adult life to levels consistent with adult obstructive lung disease. Fundamentally, we believe that this severe asthma group start with a lesser baseline lung function and gradually deteriorate to the levels consistent with a diagnosis of COPD. At this stage, there is no data on when airway remodeling occurs in children and hence, its impact on lung function, but there is an emerging relationship between childhood severe asthma and adult obstructive lung disease."
Importantly, this study was performed on a group of children recruited in the 1960s when anti-inflammatory treatment was not available. Studies to date suggest that anti-inflammatory medications do not alter the natural progression of mild childhood asthma, but there are no studies performed in those children with severe asthma.
"There should be greater emphasis on the surveillance and treatment of children with asthma, therefore potentially preventing the development of adult obstructive lung disease," said Dr. Tai.
Researchers still do not fully understand the mechanisms that link severe childhood asthma with adult COPD, but these findings suggest that appropriate treatment strategies (and surveillance) should be instigated early in life to potentially minimize future risk.
"Early treatment to prevent airway remodeling in childhood may reduce the incidence of this long-term complication of childhood asthma," concluded Dr. Tai.
"Currently, there are more than 30 birth cohort studies of varying duration being conducted around the world. In particular, the long-term follow-up of the Tucson birth cohort into young adulthood has shown trends similar to our findings of airway obstruction originating from early life. Clearly, more research to understand the mechanisms and timing of changes within the airway wall, inflammation and function needs to be conducted, applying preferably non-invasive methods in determining potential contributing factors."
"Pediatric Origins of Adult Chronic Obstructive Pulmonary Disease (COPD): Childhood Asthma" (Session A95, Sunday, May 16, 1:30-4:00 p.m., CC-Room 295-296 (Second Level), Morial Convention Center; Abstract 2206)
Source
American Thoracic Society (ATS)
The results will be presented at the ATS 2010 International Conference in New Orleans.
"There is important epidemiological evidence to suggest that events in childhood that influence lung growth constitute a significant risk for COPD," explained lead author, Andrew Tai, MBBS, FRACP. "The aim of this study was to describe the association between the pattern of childhood asthma and the risk of developing adult COPD in a longitudinal cohort."
Subjects of the Melbourne Asthma Study were recruited at the age of seven, from a 1957 birth cohort and were assessed regularly until the age of 50. At recruitment, subjects were classified as having no history of wheeze, intermittent asthma (such as viral-induced wheezing), persistent asthma (in the absence of illness), or severe asthma. Of the surviving members of the original group, 197 answered a detailed questionnaire and underwent lung function testing for the current study.
Subjects who were classified as having severe asthma in childhood had an adjusted risk of COPD of 31.9 times that of children without asthma. Interestingly, children with mild asthma were not at increased risk of developing adult obstructive lung disease.
"At this stage, children with mild asthma are those who have symptoms of wheeze which are triggered primarily by respiratory infections. A majority [of children with mild asthma] remit by adolescence or adulthood," explained Dr. Tai. "However, children with more severe asthma features tend to have predisposing risk factors (like atopy) and continue to have symptoms of wheeze well into adult life."
"It is important to emphasize that the lung function decline in this group is not increased compared to those with mild or no asthma, as has been raised in some other studies," Dr. Tai continued. "However, lung function in children with severe asthma are reduced in childhood years and decline in adult life to levels consistent with adult obstructive lung disease. Fundamentally, we believe that this severe asthma group start with a lesser baseline lung function and gradually deteriorate to the levels consistent with a diagnosis of COPD. At this stage, there is no data on when airway remodeling occurs in children and hence, its impact on lung function, but there is an emerging relationship between childhood severe asthma and adult obstructive lung disease."
Importantly, this study was performed on a group of children recruited in the 1960s when anti-inflammatory treatment was not available. Studies to date suggest that anti-inflammatory medications do not alter the natural progression of mild childhood asthma, but there are no studies performed in those children with severe asthma.
"There should be greater emphasis on the surveillance and treatment of children with asthma, therefore potentially preventing the development of adult obstructive lung disease," said Dr. Tai.
Researchers still do not fully understand the mechanisms that link severe childhood asthma with adult COPD, but these findings suggest that appropriate treatment strategies (and surveillance) should be instigated early in life to potentially minimize future risk.
"Early treatment to prevent airway remodeling in childhood may reduce the incidence of this long-term complication of childhood asthma," concluded Dr. Tai.
"Currently, there are more than 30 birth cohort studies of varying duration being conducted around the world. In particular, the long-term follow-up of the Tucson birth cohort into young adulthood has shown trends similar to our findings of airway obstruction originating from early life. Clearly, more research to understand the mechanisms and timing of changes within the airway wall, inflammation and function needs to be conducted, applying preferably non-invasive methods in determining potential contributing factors."
"Pediatric Origins of Adult Chronic Obstructive Pulmonary Disease (COPD): Childhood Asthma" (Session A95, Sunday, May 16, 1:30-4:00 p.m., CC-Room 295-296 (Second Level), Morial Convention Center; Abstract 2206)
Source
American Thoracic Society (ATS)
Patients dislike hospital admission more than worsening symptoms in exacerbations of COPD
To contact us Click HERE
Exacerbations of COPD - an acute worsening of symptoms, often triggered by a respiratory infection, requiring medical intervention and often hospitalisation - are extremely distressing for patients with this condition and their families.
But what features of exacerbations do patients with COPD consider most important and most distressing?
In this study, undertaken by John Haughney (University of Aberdeen, UK) and his European colleagues, 125 patients from five countries with recurring exacerbations of COPD were interviewed face-to-face. This study was the first of its kind to use discrete-choice modelling in COPD.
Discrete-choice modelling is a powerful tool, which, through forcing choice, allows measurement of the relative importance of different features of a scenario, in this case exacerbations of COPD. It has been used widely in commercial situations and a number of studies have now been reported in the medical literature.
Contrary to a popularly held belief that symptom control is the main aim of treatment, the authors report that the feature that most patients with COPD desire at the time of an exacerbation is not to be housebound, and, in particular, not to be admitted to hospital.
These features ranked as more important than relief of breathlessness, cough and speed of recovery.
The authors conclude that clinicians should focus their efforts on minimising the frequency and severity of exacerbations; the relief of symptoms, such as breathlessness and cough, is not enough.
The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 7,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).
European Respiratory Journal
But what features of exacerbations do patients with COPD consider most important and most distressing?
In this study, undertaken by John Haughney (University of Aberdeen, UK) and his European colleagues, 125 patients from five countries with recurring exacerbations of COPD were interviewed face-to-face. This study was the first of its kind to use discrete-choice modelling in COPD.
Discrete-choice modelling is a powerful tool, which, through forcing choice, allows measurement of the relative importance of different features of a scenario, in this case exacerbations of COPD. It has been used widely in commercial situations and a number of studies have now been reported in the medical literature.
Contrary to a popularly held belief that symptom control is the main aim of treatment, the authors report that the feature that most patients with COPD desire at the time of an exacerbation is not to be housebound, and, in particular, not to be admitted to hospital.
These features ranked as more important than relief of breathlessness, cough and speed of recovery.
The authors conclude that clinicians should focus their efforts on minimising the frequency and severity of exacerbations; the relief of symptoms, such as breathlessness and cough, is not enough.
The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 7,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).
European Respiratory Journal
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